{"id":60062,"date":"2024-02-28T06:31:39","date_gmt":"2024-02-28T06:31:39","guid":{"rendered":"https:\/\/medsname.com\/dilantin\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"dilantin","status":"publish","type":"product","link":"https:\/\/medsbase.com\/ro\/product\/dilantin\/","title":{"rendered":"Dilantin"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 R\u0103spuns rapid \u2014 Ce este Dilantin?<\/h3>\n<p style=\"margin:0;\"><strong>Dilantin<\/strong> este un <strong>fenitoin\u0103 sodiu<\/strong> (100 mg) capsule cu eliberare prelungit\u0103 \u2014 un anticonvulsivant <strong>de prima genera\u021bie din clasa hidantoinelor<\/strong> utilizat pentru <strong>crize tonico-clonice (grand mal)<\/strong>, <strong>crize par\u021biale complexe<\/strong>, \u0219i <strong>prevenirea crizelor dup\u0103 neurochirurgie<\/strong>. Ac\u021bioneaz\u0103 prin blocarea canalelor de sodiu dependente de voltaj din neuroni, stabiliz\u00e2nd starea inactivat\u0103 \u0219i prevenind desc\u0103rc\u0103rile repetate. Doza obi\u0219nuit\u0103 pentru adul\u021bi: <strong>300\u2013400 mg\/zi<\/strong> \u00een 1\u20132 doze divizate (formele cu eliberare prelungit\u0103 permit administrarea o dat\u0103 pe zi). Interval terapeutic: <strong>10\u201320 \u00b5g\/mL<\/strong> \u2014 necesit\u0103 monitorizare datorit\u0103 <strong>farmacocineticii neliniare (saturabile)<\/strong>. Efecte secundare frecvente: hiperplazie gingival\u0103, ataxie, nistagm, hirsutism, \u00een\u0103spritea tr\u0103s\u0103turilor faciale. Numeroase interac\u021biuni medicamentoase prin induc\u021bia CYP2C9\/2C19.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Ce beneficii ofer\u0103 MedsBase:<\/strong> Produc\u0103tor certificat WHO-GMP \u00b7 Ambalaj discret \u00b7 Livrare la nivel mondial \u00b7 Peste 1.400 de recenzii verificate <a href=\"https:\/\/medsbase.com\/ro\/reviews\/\">ale clien\u021bilor<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Fiecare comand\u0103 este acoperit\u0103 de politica noastr\u0103 de <a href=\"https:\/\/medsbase.com\/ro\/medsbase-re-shipment-assurance-policy\/\"><strong>Politica noastr\u0103 de Reexpediere Garantat\u0103<\/strong><\/a> \u2014 dac\u0103 coletul dumneavoastr\u0103 nu sose\u0219te \u00een 20 de zile lucr\u0103toare, \u00eel relivr\u0103m.<\/p>\n<h3>De ce s\u0103 comanzi de la MedsBase<\/h3>\n<p>Medicamentele noastre generice sunt procurate de la produc\u0103tori certifica\u021bi WHO-GMP \u0219i expediate la nivel mondial \u00een ambalaje discrete \u0219i simple \u2014 f\u0103r\u0103 denumirea medicamentului pe exteriorul coletului. Pl\u0103\u021bile cu cardul sunt procesate printr-un procesor reglementat (descrierile de pe extrasul de cont includ un procesor de pl\u0103\u021bi cu card reglementat \u2014 niciodat\u0103 \u201cMedsBase\u201d sau numele vreunui medicament). Accept\u0103m \u0219i criptomonede \u0219i transferuri bancare SEPA. Fiecare comand\u0103 este sus\u021binut\u0103 de Politica noastr\u0103 de Asigurare pentru Relivrare.<\/p>\n<h2 class=\"wp-block-heading\">Ce este Dilantin?<\/h2>\n<p>Dilantin este o capsul\u0103 cu eliberare prelungit\u0103 care con\u021bine <strong>fenitoin\u0103 sodiu 100 mg<\/strong>. Fenitoina este unul dintre cele mai vechi \u0219i mai utilizate anticonvulsivante, \u00een uz clinic continuu din <strong>1938<\/strong> \u2014 f\u0103c\u00e2ndu-l unul dintre cele mai studiate medicamente din medicin\u0103.<\/p>\n<p>Fenitoina stabilizeaz\u0103 membranele neuronale prin blocarea canalelor de sodiu dependente de voltaj, prevenind desc\u0103rc\u0103rile repetate care stau la baza propag\u0103rii crizelor. Este inclus\u0103 pe <strong>Lista Model OMS a Medicamentelor Esen\u021biale<\/strong> \u0219i r\u0103m\u00e2ne o op\u021biune de prim\u0103 linie pentru <strong>tonic-clonice<\/strong> \u0219i <strong>crizelor focale<\/strong>. Dilantin este marca original\u0103 dezvoltat\u0103 de Parke-Davis (acum Pfizer) \u0219i reprezint\u0103 standardul de referin\u021b\u0103 pentru toate medicamentele generice cu fenitoin\u0103.<\/p>\n<p>Fenitoina este unic\u0103 printre anticonvulsivante datorit\u0103 <strong>cineticii de ordin zero (saturabile)<\/strong> la doze terapeutice: modific\u0103ri mici ale dozei pot produce modific\u0103ri dispropor\u021bionat mari ale nivelurilor sanguine. Acesta este motivul pentru care <strong>monitorizarea terapeutic\u0103 a medicamentului (TDM)<\/strong> este obligatorie \u00een cazul fenitoinei \u2014 o caracteristic\u0103 care o face mai dificil de prescris dec\u00e2t medicamentele mai noi, dar \u0219i cea mai fin reglabil\u0103 atunci c\u00e2nd este utilizat\u0103 de clinicieni experimenta\u021bi.<\/p>\n<h2 class=\"wp-block-heading\">Cum func\u021bioneaz\u0103 Dilantin (Fenitoina)?<\/h2>\n<p>Fenitoina blocheaz\u0103 <strong>canalele de sodiu dependente de voltaj<\/strong> prin legarea preferen\u021bial\u0103 la starea lor inactivat\u0103. Acest lucru prelunge\u0219te perioada refractar\u0103 a neuronilor, prevenind activarea rapid\u0103 repetat\u0103 care st\u0103 la baza propag\u0103rii crizelor. Spre deosebire de anticonvulsivantele mai noi care ac\u021bioneaz\u0103 pe mai multe \u021binte, fenitoina este un blocant relativ selectiv al canalelor de sodiu.<\/p>\n<p>Critic, fenitoina prezint\u0103 <strong>farmacocinetica neliniar\u0103 (de ordin zero, saturabil\u0103)<\/strong> descris\u0103 de ecua\u021bia Michaelis-Menten. Aceasta \u00eenseamn\u0103 c\u0103 cre\u0219teri mici ale dozei aproape de satura\u021bie pot produce <strong>cre\u0219teri dispropor\u021bionat mari<\/strong> ale nivelurilor sanguine, f\u0103c\u00e2nd monitorizarea terapeutic\u0103 a medicamentului esen\u021bial\u0103.<\/p>\n<h2 class=\"wp-block-heading\">Indica\u021bii<\/h2>\n<ul>\n<li><strong>Crize generalizate tonic-clonice (grand mal)<\/strong><\/li>\n<li><strong>Crize par\u021biale complexe (focale)<\/strong><\/li>\n<li><strong>Statu epileptic<\/strong> (doz\u0103 de \u00eenc\u0103rcare IV \u2014 nu aceast\u0103 form\u0103 oral\u0103)<\/li>\n<li><strong>Profilaxia crizelor post-neurochirurgicale\/post-traumatism cerebral<\/strong><\/li>\n<li>Neuralgia trigeminal\u0103 (linia a doua, off-label)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Doze \u0219i Monitorizare Terapeutic\u0103 a Medicamentului<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:0 0 24px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px 14px;text-align:left;\">Parametru<\/th>\n<th style=\"padding:10px 14px;text-align:left;\">Valoare<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px 14px;\">Doza uzual\u0103 pentru adul\u021bi<\/td>\n<td style=\"padding:10px 14px;\">300\u2013400 mg\/zi (o dat\u0103 pe zi sau \u00eemp\u0103r\u021bit\u0103)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Doza de \u00eenc\u0103rcare (dac\u0103 este necesar\u0103)<\/td>\n<td style=\"padding:10px 14px;\">1.000 mg \u00eemp\u0103r\u021bit \u00een 3 doze \u00een 24 h (\u00eenc\u0103rcare oral\u0103)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">Interval terapeutic (total)<\/td>\n<td style=\"padding:10px 14px;\">10\u201320 \u00b5g\/mL<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Nivel liber (nelegat)<\/td>\n<td style=\"padding:10px 14px;\">1\u20132 \u00b5g\/mL (verifica\u021bi \u00een hipoalbuminemie, insuficien\u021b\u0103 renal\u0103)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">Ajust\u0103ri de doz\u0103<\/td>\n<td style=\"padding:10px 14px;\">Incremente de doar 25\u201350 mg (cinetic\u0103 neliniar\u0103)<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">Timp p\u00e2n\u0103 la stabilizare<\/td>\n<td style=\"padding:10px 14px;\">5\u201314 zile (mai mult la doze mai mari)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Important:<\/strong> Capsulele cu eliberare prelungit\u0103 (Dilantin Kapseals) trebuie \u00eenghi\u021bite \u00eentregi, nu mestecate sau zdrobite. Fenitoina generic\u0103 cu eliberare prelungit\u0103 nu este \u00eentotdeauna interschimbabil\u0103 cu marca de referin\u021b\u0103 \u2014 discuta\u021bi schimbarea cu medicul dumneavoastr\u0103.<\/p>\n<h2 class=\"wp-block-heading\">Efecte Secundare<\/h2>\n<p><strong>Frecvente:<\/strong> hiperplazie gingival\u0103 (cre\u0219tere excesiv\u0103 a gingiilor, p\u00e2n\u0103 la 50% dintre utilizatorii pe termen lung), nistagmus, ataxie, vorb\u0103 \u00eeng\u0103imat\u0103, somnolen\u021b\u0103, hirsutism, acnee, \u00een\u0103spritea tr\u0103s\u0103turilor faciale.<\/p>\n<p><strong>Semne de toxicitate legate de doz\u0103 (\u00een ordinea apari\u021biei):<\/strong><\/p>\n<table style=\"width:100%;border-collapse:collapse;margin:0 0 24px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px 14px;\">Nivel seric<\/th>\n<th style=\"padding:10px 14px;\">Semne<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px 14px;\">&gt;20 \u00b5g\/mL<\/td>\n<td style=\"padding:10px 14px;\">Nistagmus<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">&gt;30 \u00b5g\/mL<\/td>\n<td style=\"padding:10px 14px;\">Ataxie, vorbire \u00eenceat\u0103<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 14px;\">&gt;40 \u00b5g\/mL<\/td>\n<td style=\"padding:10px 14px;\">Confuzie, letargie<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px 14px;\">&gt;50 \u00b5g\/mL<\/td>\n<td style=\"padding:10px 14px;\">Convulsii (paradoxale), com\u0103<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Efecte grave\/pe termen lung:<\/strong> osteomalacie (interferen\u021b\u0103 cu metabolismul vitaminei D), anemie megaloblastic\u0103 (epuizare de folat), sindrom Stevens-Johnson\/TEN (rar \u2014 risc crescut la purt\u0103torii HLA-B*1502, frecvent \u00een popula\u021biile din Asia de Sud-Est), hepatotoxicitate, sindromul m\u0103nu\u0219ei purpurii (extravazare IV \u2014 nu se aplic\u0103 la utilizarea oral\u0103), atrofie cerebeloas\u0103 (niveluri supraterapeutice cronice).<\/p>\n<h2 class=\"wp-block-heading\">Avertismente \u0219i precau\u021bii<\/h2>\n<ul>\n<li><strong>Monitorizarea terapeutic\u0103 a medicamentului este obligatorie.<\/strong> Nivelul \u021bint\u0103 pentru fenitoin\u0103 total\u0103: 10\u201320 \u00b5g\/mL (fenitoin\u0103 liber\u0103: 1\u20132 \u00b5g\/mL). Cinetic\u0103 de ordin zero \u00eenseamn\u0103 c\u0103 o mic\u0103 cre\u0219tere a dozei (de ex., de la 300 la 330 mg\/zi) poate duce nivelurile \u00een zona toxic\u0103. Verifica\u021bi nivelurile la 7\u201310 zile dup\u0103 orice modificare a dozei.<\/li>\n<li><strong>Comportament suicidal \u2014 avertizare de clas\u0103.<\/strong> Toate medicamentele antiepileptice poart\u0103 un avertisment FDA privind cre\u0219terea g\u00e2ndurilor suicidare. Monitoriza\u021bi starea emo\u021bional\u0103, \u00een special \u00een primele 3 luni.<\/li>\n<li><strong>Reac\u021bii cutanate adverse severe (SCARs).<\/strong> Fenitoina prezint\u0103 risc de <strong>sindromul Stevens-Johnson (SJS)<\/strong> \u0219i <strong>necroz\u0103 epidermic\u0103 toxic\u0103 (TEN)<\/strong>, \u00een special la pacien\u021bii cu <strong>HLA-B*15:02<\/strong> (frecvent \u00een popula\u021biile din Asia de Sud-Est). Testa\u021bi prezen\u021ba HLA-B*15:02 \u00eenainte de a ini\u021bia tratamentul cu fenitoin\u0103 la popula\u021biile cu risc.<\/li>\n<li><strong>Sindromul DRESS.<\/strong> Reac\u021bie medicamentoas\u0103 cu eozinofilie \u0219i simptome sistematice \u2014 debutul apare de obicei la 2\u20138 s\u0103pt\u0103m\u00e2ni dup\u0103 \u00eenceperea tratamentului. Se manifest\u0103 prin febr\u0103, erup\u021bie cutanat\u0103, limfadenopatie \u0219i afectare organic\u0103 (ficat, rinichi). \u00centrerupe\u021bi imediat tratamentul.<\/li>\n<li><strong>Hiperplazie gingival\u0103.<\/strong> Apare la ~50% dintre utilizatorii cronici. Igiena oral\u0103 meticuloas\u0103 reduce severitatea. Lua\u021bi \u00een considerare alternative pentru pacien\u021bii tineri cu preocup\u0103ri cosmetice.<\/li>\n<li><strong>Hepatotoxicitate.<\/strong> Rar\u0103, dar poate fi sever\u0103, \u00een special \u00een cazul DRESS. Monitoriza\u021bi testele hepatice (LFTs) dac\u0103 apar febr\u0103 sau erup\u021bie cutanat\u0103.<\/li>\n<li><strong>Sarcina \u2014 categoria D.<\/strong> Fenitoina este teratogen\u0103 (sindromul fetal hidantoinic: anomalii craniofaciale, ale unghiilor \u0219i ale degetelor, restric\u021bie de cre\u0219tere). Utiliza\u021bi numai dac\u0103 nu exist\u0103 alt\u0103 alternativ\u0103 pentru controlul crizelor. Acid folic 5 mg\/zi \u00eenainte de concep\u021bie. Vitamina K 10 mg\/zi \u00een ultima lun\u0103 (fenitoina epuizeaz\u0103 vitamina K fetal\u0103 \u2192 hemoragie neonatal\u0103).<\/li>\n<li><strong>Osteoporoza.<\/strong> Fenitoina pe termen lung induce enzimele CYP care metabolizeaz\u0103 vitamina D, duc\u00e2nd la osteomalacie. Suplimenta\u021bi cu vitamina D 1.000\u20132.000 UI\/zi \u0219i monitoriza\u021bi scan\u0103rile DEXA.<\/li>\n<li><strong>Nutri\u021bie enteral\u0103.<\/strong> Hr\u0103nirea prin sond\u0103 reduce absorb\u021bia fenitoinei cu p\u00e2n\u0103 la 70%. Suspend\u0103 hr\u0103nirea cu 2 ore \u00eenainte \u0219i dup\u0103 administrare.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Contraindica\u021bii \u2014 Cine NU ar trebui s\u0103 ia Dilantin<\/h2>\n<ul>\n<li>Hipersensibilitate cunoscut\u0103 la fenitoin\u0103, alte hidantoine sau orice excipient<\/li>\n<li>Utilizare concomitent\u0103 cu <strong>delavirdin\u0103<\/strong> (NNRTI HIV \u2014 fenitoina reduce delavirdina la niveluri subterapeutice)<\/li>\n<li>Bradicardie sinusal\u0103, bloc sino-atrial, bloc AV de gradul doi\/trei, sindromul Adams-Stokes<\/li>\n<li>Pacien\u021bi pozitivi pentru <strong>HLA-B*15:02<\/strong> (cu excep\u021bia cazului \u00een care nu exist\u0103 alt\u0103 alternativ\u0103 \u0219i beneficiul dep\u0103\u0219e\u0219te clar riscul de SJS\/TEN)<\/li>\n<li>Porfire<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Interac\u021biuni medicamentoase<\/h2>\n<p>Fenitoina este at\u00e2t un <strong>substrat<\/strong> \u0219i <strong>induc\u0103tor<\/strong> al CYP2C9, CYP2C19 \u0219i CYP3A4, f\u0103c\u00e2ndu-l unul dintre anticonvulsivantele cu cele mai multe interac\u021biuni:<\/p>\n<ul>\n<li><strong>Medicamente care cresc nivelurile de fenitoin\u0103:<\/strong> fluconazol, izoniazid, omeprazol, amiodaron, fluoxetin\u0103, valproat, trimetoprim<\/li>\n<li><strong>Medicamente ale c\u0103ror niveluri fenitoina le scade:<\/strong> warfarin (paradoxal: fenitoina ini\u021bial deplaseaz\u0103 apoi induce metabolismul), contraceptive orale, ciclosporin\u0103, dexametazon\u0103, teofilin\u0103, doxiciclin\u0103, lamotrigin\u0103, carbamazepin\u0103, metadon\u0103<\/li>\n<li><strong>Nutri\u021bie enteral\u0103:<\/strong> Nutri\u021bia continu\u0103 prin sond\u0103 reduce absorb\u021bia fenitoinei \u2014 \u00eentrerupe\u021bi alimentarea cu 2 ore \u00eenainte \u0219i dup\u0103 administrare<\/li>\n<li><strong>Alcool:<\/strong> Utilizarea cronic\u0103 induce metabolismul (niveluri mai sc\u0103zute); intoxica\u021bia acut\u0103 inhib\u0103 metabolismul (niveluri mai ridicate)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Instruc\u021biuni de Depozitare<\/h2>\n<ul>\n<li>Se p\u0103streaz\u0103 la temperatura camerei, <strong>15\u201330\u00b0C<\/strong>. Proteja\u021bi de umiditate \u0219i lumin\u0103.<\/li>\n<li>P\u0103stra\u021bi capsulele \u00een ambalajul original blister p\u00e2n\u0103 la utilizare.<\/li>\n<li>Nu depozita\u021bi \u00een baie.<\/li>\n<li>\u021aine\u021bi departe de copii \u2014 supradozarea de fenitoin\u0103 reprezint\u0103 o urgen\u021b\u0103 medical\u0103 (nistagm \u2192 ataxie \u2192 com\u0103).<\/li>\n<li>Nu utiliza\u021bi dup\u0103 data de expirare.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Categorii conexe pe MedsBase<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/neurological-conditions-and-epilepsy\/\">R\u0103sfoi\u021bi toate medicamentele neurologice \u0219i antiepileptice<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/pain-relief-medication\/\">R\u0103sfoi\u021bi medicamente pentru durere<\/a><\/li>\n<\/ul>\n<h2 id=\"faqs\">\u00centreb\u0103ri frecvente<\/h2>\n<h3 class=\"wp-block-heading\">Pentru ce se utilizeaz\u0103 Dilantin?<\/h3>\n<p>Dilantin con\u021bine <strong>fenitoin\u0103 100 mg<\/strong> \u0219i este utilizat pentru controlul \u0219i prevenirea <strong>crizelor tonico-clonice \u0219i a celor par\u021biale complexe<\/strong> \u00een epilepsie, precum \u0219i pentru prevenirea crizelor dup\u0103 interven\u021bii chirurgicale la creier sau traumatisme craniene.<\/p>\n<h3 class=\"wp-block-heading\">De ce este necesar monitorizarea nivelului sanguin al fenitoinei?<\/h3>\n<p>Fenitoina prezint\u0103 <strong>farmacocinetica neliniar\u0103<\/strong> \u2014 sistemul enzimatic care o metabolizeaz\u0103 devine saturat la dozele terapeutice. O cre\u0219tere mic\u0103 a dozei (de ex., 300 \u2192 350 mg) poate determina o cre\u0219tere dispropor\u021bionat mare a nivelului sanguin, de la terapeutic la toxic. Monitorizarea regulat\u0103 men\u021bine nivelul \u00een <strong>fereastra terapeutic\u0103 10\u201320 \u00b5g\/mL<\/strong>.<\/p>\n<h3 class=\"wp-block-heading\">Ce este hiperplazia gingival\u0103 \u0219i poate fi prevenit\u0103?<\/h3>\n<p>Hiperplazia gingival\u0103 reprezint\u0103 cre\u0219terea excesiv\u0103 a gingiilor, care apare la p\u00e2n\u0103 la <strong>50%<\/strong> la pacien\u021bii care iau fenitoin\u0103 pe termen lung. Igiena oral\u0103 bun\u0103 (periaj regulat, folosirea a\u021bei dentare, controale dentare periodice) reduce severitatea dar nu o elimin\u0103. Schimbarea la un alt anticonvulsivant este solu\u021bia definitiv\u0103 atunci c\u00e2nd modific\u0103rile gingivale devin problematice.<\/p>\n<h3 class=\"wp-block-heading\">Pot comuta \u00eentre fenitoina de marc\u0103 \u0219i cea generic\u0103?<\/h3>\n<p>Formulele de eliberare prelungit\u0103 a fenitoinei pot diferi \u00een ceea ce prive\u0219te caracteristicile de absorb\u021bie \u00eentre produc\u0103tori. Unele recomand\u0103ri sugereaz\u0103 <strong>s\u0103 nu se fac\u0103 schimb\u0103ri<\/strong> \u00eentre m\u0103rci\/generice f\u0103r\u0103 monitorizarea nivelului, deoarece chiar \u0219i mici modific\u0103ri ale biodisponibilit\u0103\u021bii pot duce nivelurile \u00een afara ferestrei terapeutice \u00eenguste.<\/p>\n<h3 class=\"wp-block-heading\">De ce ar trebui evitat\u0103 fenitoina \u00een cazul crizei de absen\u021b\u0103?<\/h3>\n<p>Fenitoina (\u0219i carbamazepina) pot <strong>agrava crizele de absen\u021b\u0103 (petit mal)<\/strong> prin alterarea ritmurilor talamocorticale. Tratamentele de prim\u0103 linie pentru crizele de absen\u021b\u0103 sunt etosuximida, valproatul sau lamotrigina.<\/p>\n<h3 class=\"wp-block-heading\">Fenitoina afecteaz\u0103 s\u0103n\u0103tatea osoas\u0103?<\/h3>\n<p>Da \u2014 utilizarea pe termen lung a fenitoinei induce enzime CYP care accelereaz\u0103 metabolismul vitaminei D, duc\u00e2nd la <strong>osteomalacie \u0219i risc crescut de fracturi<\/strong>. Pacien\u021bii care iau fenitoin\u0103 pe termen lung ar trebui s\u0103 ia suplimente de vitamina D \u0219i calciu \u0219i s\u0103 efectueze screening periodic al densit\u0103\u021bii osoase.<\/p>\n<h3 class=\"wp-block-heading\">Este Dilantin sigur \u00een timpul sarcinii?<\/h3>\n<p>Fenitoina este un medicament cunoscut <strong>teratogen<\/strong> (sindromul hidantoinic fetal: restric\u021bie de cre\u0219tere, anomalii craniofaciale, defecte ale membrelor). Ar trebui \u00eenlocuit cu un anticonvulsivant mai sigur (lamotrigin\u0103 sau levetiracetam) \u00eenainte de concep\u021bie, atunci c\u00e2nd este posibil. Dac\u0103 fenitoina trebuie continuat\u0103, suplimentarea cu folat \u00een doze mari \u0219i monitorizarea de specialitate sunt esen\u021biale.<\/p>\n<h3 class=\"wp-block-heading\">Ce ar trebui s\u0103 fac dac\u0103 uit s\u0103 iau o doz\u0103 de Dilantin?<\/h3>\n<p>Lua\u021bi-o c\u00e2t mai cur\u00e2nd posibil. Dac\u0103 este aproape de urm\u0103toarea doz\u0103 programat\u0103, omite\u021bi doza ratat\u0103. Nu lua\u021bi niciodat\u0103 o dobl\u0103 \u2014 datorit\u0103 cineticii neliniare, dublarea unei doze poate duce la niveluri toxice.<\/p>\n<h3 class=\"wp-block-heading\">De ce se men\u021bioneaz\u0103 testarea HLA-B*1502 \u00een cazul fenitoinei?<\/h3>\n<p>Numele <strong>HLA-B*1502<\/strong> alela (frecvent\u0103 \u00een popula\u021biile din Asia de Sud-Est) este puternic asociat\u0103 cu <strong>sindromul Stevens-Johnson (SJS) \u0219i necroliza epidermal\u0103 toxic\u0103 (TEN)<\/strong> \u2014 reac\u021bii cutanate poten\u021bial letale. Testarea este recomandat\u0103 \u00eenainte de ini\u021bierea fenitoinei la popula\u021biile cu risc.<\/p>\n<h3 class=\"wp-block-heading\">Pot lua antiacide \u00eempreun\u0103 cu Dilantin?<\/h3>\n<p>Antiacidele care con\u021bin calciu \u0219i aluminiu pot reduce absorb\u021bia fenitoinei. Administra\u021bi-le cu <strong>un interval de cel pu\u021bin 2 ore<\/strong>.<\/p>\n<h3 class=\"wp-block-heading\">Dilantin este este acela\u0219i lucru cu Epanutin?<\/h3>\n<p>Ambele con\u021bin fenitoin\u0103. Dilantin \u0219i Epanutin sunt denumiri comerciale utilizate pe pie\u021be diferite. Acest produs utilizeaz\u0103 denumirea Dilantin \u0219i con\u021bine aceea\u0219i formul\u0103 de 100 mg de fenitoin\u0103 sodic\u0103.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;font-size:13px;\"><strong>Avertizare medical\u0103:<\/strong> Aceast\u0103 pagin\u0103 are scop informativ \u0219i nu \u00eenlocuie\u0219te sfatul medical profesionist. Consulta\u021bi \u00eentotdeauna un furnizor de servicii medicale calificat \u00eenainte de a \u00eencepe, modifica sau \u00eentrerupe orice medica\u021bie. Informa\u021biile privind dozarea reflect\u0103 eticheta produc\u0103torului \u0219i ghidurile clinice publicate \u2014 cerin\u021bele individuale pot diferi.<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Alternative conexe<\/h3>\n<p>Alte produse din <strong>Afec\u021biuni cronice<\/strong> pe care clien\u021bii le vizualizeaz\u0103 de asemenea:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/ro\/lefuheal\/\">Lefuheal<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/reactin-sr\/\">Reactin SR<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/anaridex\/\">Anaridex<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/gravitor\/\">Gravitor<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/ro\/erythego-gel\/\">Erythego Gel<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Controlul crizelor<br \/>\n\u2705 Previne convulsiile<br \/>\n\u2705 Trateaz\u0103 epilepsia<br \/>\n\u2705 Stabilizeaz\u0103 activitatea cerebral\u0103<br \/>\n\u2705 Reduce frecven\u021ba crizelor<\/p>\n<p>Dilantin con\u021bine Fenitoin\u0103.<\/p>","protected":false},"featured_media":60063,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3468],"product_tag":[4793,4794],"class_list":{"0":"post-60062","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-neurological-conditions-and-epilepsy","9":"product_tag-dilantin","10":"product_tag-phenytoin","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product\/60062","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/comments?post=60062"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media\/60063"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/media?parent=60062"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_brand?post=60062"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_cat?post=60062"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/ro\/wp-json\/wp\/v2\/product_tag?post=60062"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}